MIS 260 Life and Health Insurance Syllabus

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MIS 260 Life and Health Insurance Syllabus Powered By Docstoc
					                        Life and Health Insurance
                                 MIS 260
                          University of Montana
                     School of Business Administration
Jack Morton, J.D.
Office: Gallagher 324
Office Hours - Tuesday and Thursday 8 a.m. – 12 p.m. MST
Phone: 406-243-6717 486-6422
Fax: 406-243-6191

Mission Statement:
The University of Montana’s School of Business Administration is a collegial learning
community dedicated to the teaching, exploration, and application of the knowledge and
skills necessary to succeed in a competitive marketplace.

Course Description:
This course will provide an understanding of the principles of both life and health
insurance. Primary attention is directed towards the economic purpose, structure,
operation, and performance of the life and health industries. Emphasis is placed on
underwriting, pricing, and marketing these insurance policies. The relationship of life
insurance and health insurance to Social Security and workers compensation will be
covered. In addition, the course will explore the relationship between health insurance
and the government sponsored workers compensation, Medicare, and Medicaid
programs. The primary focus of the life insurance portion of the course will be on the
various individual life insurance policies. The health portion of the course will focus on
group health policies because they cover a much larger portion of the health market than
do individual health policies. The course will develop an understanding of how the
private life and health insurance policies combine with the public options of workers
compensation, Social Security, Medicare, and Medicaid to provide numerous but
complex options for the consumer.

Course Objectives:
The course objectives are to: (1) create an awareness of the shortcomings in the basic but
minimal government life and health insurance programs; (2) examine the various
methods of using private insurance to supplement the government life and health
insurance programs; and (3) examine the federal and state legal environment which
serves to regulate the life and health industries to provide choice, a degree of uniformity,
and consumer protection.

Course Format and Method of Evaluation:

Lectures and discussions characterize the typical class. Students are graded on the basis
of the following:

      A chapter quiz will be given after each of the 34 chapters. The chapter quiz
       scores will be averaged and that score will count 25% of the course grade.
       Discussion articles (usually from the Wall Street Journal) will be posted to the
        discussion board for each chapter. Students are encouraged to post their own
        articles. For each chapter, students are expected to post an average of three
        substantive comments to the discussion board. Students are encouraged to
        comment on postings made by other students. The discussion board activity will
        count 25% of the course grade.

       A comprehensive final course exam will be given after Chapter 34. The
        comprehensive final course exam will count 50% of the course grade.

Academic Integrity:
Academic misconduct is subject to an academic penalty by the course instructor and/or a
disciplinary sanction by the University. Any students found engaged in academic
dishonesty will, at a minimum, receive an F for the course.

Life and Health Insurance, by

Current articles from various sources, such as the Wall Street Journal, Forbes, and
Business Week will be posted on the web site. Students will be responsible for
understanding those materials and the materials will be included in quizzes and exams.

Course Coverage and Readings:

   1)      Introduction to Insurance
                     Risk
                     Risk management
                     Self insuring
                     Types of Insurers

   2)      Social Security and Workers Compensation
                     Social Security
                     Who pays for Social Security
                     Who is covered by Social Security
                     Calculating Social Security benefits
                     Workers Compensation and its relationship to life and health insurance

   3)      Underwriting Life and Health Insurance
                     Factors in the underwriting process
                     Sources of underwriting information
                     The medical exam
                     Making the underwriting decision
                     Calculating premiums
                     Premium mode

4)    Group Insurance – The Basics
               Group insurance characteristics
               Underwriting group policies
               Defining the group
               Contributory versus noncontributory group policies
               Voluntary employer sponsored plans

5)    Contract Law Issues
               Elements of a contract
               Conditional receipts
               Insurance consumer fraud
               Third party ownership
               Insurable interests
               Producer responsibilities
               Uniform policy provisions

6)    Insurance Industry Regulation
               NAIC
               State insurance commissioners
               Federal Fair Credit Reporting Act
               MIB
               HIPAA and privacy issues
               Federal Do Not Call rules
               Replacement rules

7)    Accidental Death and Dismemberment Policies
               AD&D as a rider or stand alone policy
               Multiple indemnity riders
               Federal Fair Credit Reporting Act
               Beneficiary selection
               Simultaneous Death Act
               Common disaster clause
               Spendthrift trusts
               Revocable and irrevocable beneficiaries

8)    Life Insurance Basics
               Individual uses for life insurance
               Business uses for life insurance

9)    Term Life Insurance
               Annually renewable term
               Convertible term
               Level, increasing, and decreasing term

10)   Whole Life Insurance
               Features of whole life
               Premium options
               Convertibility

11)   Required Life Provisions
               NAIC required provisions

12)   Optional Life Provisions
                 Suicide clause
                 Hazardous occupation
                 Aviation provisions

13)   Life Insurance Riders
                 Automatic premium loan rider
                 Waiver of premium rider
                 Accelerated death benefit rider

14)   Policy Decisions
                 Dividend options
                 Nonforfeiture options
                 Settlement options

15)   Life Insurance in the Family Setting
                 Family policy
                 Family income policies
                 First to die/Last to die policies

16)   Life Insurance in the Business Setting
                 Key Employee Life Insurance
                 Business continuation agreements

17)   Group Life Insurance
                 Required provisions in group life policies
                 Conversion privileges
                 Taxes and group insurance

18)   Taxes and Individual Life Insurance
                 Taxing the individual policy
                 Endowment life insurance

19)   Adjustable Life Policy
                 Reasons for developing the adjustable life policy
                 Convertibility

20)   Newer Life Policies
                 Interest sensitive whole life
                 Variable life
                 Universal life
                 Variable universal life

21)   Retirement Planning
                 Nonqualified versus qualified plans
                 Individual retirement accounts (IRAs)
                 401-K plans
                 Small business retirement plans

22)   Annuities
                 Purpose of annuities
                 Pay-in options
               Pay-out options
               Taxation and annuities

23)   Health Insurance Basics
               Pre-existing conditions
               Stop-loss limits
               Renewability issues

24)   Individual Health Policies – Required Provisions
               Free Look requirement
               Reinstatement
               Time limit on certain defenses issues

25)   Individual Health – Optional Provisions
               Change of occupation
               Other insurance provisions
               Exclusions

26)   Medical Expense Policies
               History of MEPs
               Policy coverages
               Taxation of MEPs

27)   Limited Health Policies
               Accident only policies
               Sickness only policies
               Blanket policies
               Dread disease policies
               Critical illness policies

28)   Group Health Policies
               Required versus optional provisions
               Coordination of benefits
               COBRA
               HIPAA portability
               Taxation of group health policies

29)   Blues, PPOs, and HMOs
               Indemnity plans
               Blue Cross-Blue Shield coverages
               Preferred provider organizations
               Health maintenance organizations

30)   Consumer Driven Health Care
               Flex plans and taxation
               High deductible health policies
               Tax-advantaged savings accounts

31)   Medicare and Medicaid
               Medicare eligibility, coverage, and gaps
               Medicare supplement coverages
               Medicaid eligibility, funding, and coverages
32)   Long-Term Care Policies
               Need for LTCi
               Features of LTCi
               Taxation of LTCi

33)   Disability Income Policies
               Relation to Social Security
               Taxation of DI benefits
               DI riders
               Business use of DI insurance

34)   State Regulation of Life and Health Insurance
               State versus federal regulation
               State Insurance Commissioner - powers
               Regulation of insurers and producers
               State code of ethics
               Replacement regulations
               State COBRAs and HIPAAs


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